RILEY BOURDON (NPI# 1790327708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790327708 |
| Entity Type | Individual |
| Full Name | RILEY BOURDON |
| Practice Address |
1104 W River Rd Detroit Lakes MN 56501-2723 |
| Mailing Address |
891 Belsly Blvd Moorhead MN 56560-5055 |
| Practice Telephone | 2182874338 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1104 W RIVER RD |
| City | DETROIT LAKES |
| State | MN |
| Zip Code | 56501-2723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104183326 | Tessie Blake | Psychologist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2012-04-12 |
| 1205443785 | Alexis Fritz | Specialist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-09-28 |
| 1669083945 | Alyssa Mertens | Specialist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-08-11 |
| 1780208314 | Austin Askelson | Specialist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-05-29 |
| 1891321048 | Kelse Sandberg | Specialist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-03-19 |
| 1932734001 | Jennifer Lehmann | Specialist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-03-09 |
| 1316571706 | Rachael Mcarthur | Technician, Other | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-02-25 |
| 1811520273 | Jennifer Wendlandt | Social Worker | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-02-13 |
| 1568008522 | Erica Johnson | Specialist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2019-11-25 |
| 1669016994 | Lauren Harting | Specialist | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2019-10-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
| 1992179386 | Compassion House | Substance Abuse Rehabilitation Facility | 811 8th St. Se, Detroit Lakes, MN 56501 | 2015-11-23 |
| 1720344286 | Lakes Crisis & Resource Center | Clinic/Center | 1339 Pelican Lane, Detroit Lakes, MN 56501 | 2012-04-09 |
| 1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
| 1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
| 1760651079 | Rapidcare Urgent Care Pllc | Family Medicine | 1361 Wenner Road, Detroit Lakes, MN 56501 | 2008-02-21 |
| 1427274729 | Jeffrey C Gregory | Psychologist | 910 Lincoln Ave, Detroit Lakes, MN 56501 | 2007-04-17 |
| 1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
| Find all providers in zip 56501 | ||||
| Taxonomy Code | 247200000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
| Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316571706 | Rachael Mcarthur | Technician, Other | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2020-02-25 |
| 1417505710 | Courtney Chezik | Technician, Other | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2019-08-29 |
| 1295294130 | Emmalee Gavle | Technician, Other | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2019-03-19 |
| 1760978159 | Kayla Harris | Technician, Other | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2018-07-09 |
| 1639682685 | Hailey Jutz | Technician, Other | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2017-11-13 |
| 1164940698 | Kyle Mills | Technician, Other | 1104 W River Rd, Detroit Lakes, MN 56501-2723 | 2017-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476324 | Ferdus Aden | Technician, Other | 7026 W 133rd Ct, Savage, MN 55378-4436 | 2020-10-30 |
| 1710584610 | Crystal Yang | Technician, Other | 1540 Etna St, Saint Paul, MN 55106-1420 | 2020-10-04 |
| 1457967895 | Lisa Eisenbacher | Technician, Other | 731 Bielenberg Dr Ste 102-103, Woodbury, MN 55125-1700 | 2020-09-21 |
| 1265045157 | Abigail Johnson | Technician, Other | 6300 W Old Shakopee Rd, Bloomington, MN 55438-2654 | 2020-08-28 |
| 1003438037 | Shannon Marie Hacka | Technician, Other | 1011 Meadowlands Dr Ste 1&2, Saint Paul, MN 55127-2339 | 2020-05-13 |
| 1457972598 | Brittin Kemp | Technician, Other | 10450 185th St W Ste 100, Lakeville, MN 55044-6696 | 2020-04-29 |
| 1184243826 | Desira Wright | Technician, Other | 320 Old Territorial Rd Ne Apt 4, Chatfield, MN 55923-1610 | 2020-04-13 |
| 1982234571 | Kennedy Rosella Tonn | Technician, Other | 1011 Meadowlands Dr, Saint Paul, MN 55127-2339 | 2020-01-22 |
| 1043850399 | Tiffany Wilschek | Technician, Other | 1470 Industrial Drive Nw, Rochester, MN 55901-0614 | 2020-01-14 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
| City | DETROIT LAKES |
| Zip Code | 56501 |
Please comment or provide details below to improve the information on RILEY BOURDON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.